This is a proposal to complete and report the analysis of data relating to the recognition, response and long term adaptation to severe mental illness on the part of families of mental patients as reconstructed through interviews with the patient's spouse beginning soon after initial hospitalization and carried through the period of hospitalization. Data collected from more than 50 families in Washington, D.C. and Maryland suburbs in 1952-60 will be supplemented by two series of interviews with spouses of patients in 1971-73, one to be obtained in the Washington area and the other in the San Francisco Bay Area. In addition, a subsample of the families and patients seen in 1952-60 will be followed-up to try to assess factors influencing the long-term impact of mental illness and hospitalization. The time span covered should permit inferences as to how major changes in community mental health facilities have influenced the meaning and consequences of the patient's illness for his family.